Cerrahi Tıp Bilimleri Bölümü Koleksiyonu

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https://hdl.handle.net/20.500.12428/2266

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Clinically significant residual stones after retrograde intrarenal surgery: Early results of a 5-year follow-up, RIRSearch group study
(Elsevier, 2025) Yazıcı, C. M.; Şahin, M. F.; Teke, K.; Şimşekoğlu, M. F.; Başataç, C.; Tuna, M. B.; Çakır, H.; Sancak, Eyüp Burak
[No abstract available]
Comparison of two different medication strategies before retrograde intrarenal surgery in patients using anticoagulant or antiplatelet agents: Results of the RIRSearch study group
(Elsevier, 2025) Şimşekoğlu, M. E.; Ozman, O.; Çakır, H.; Teke, K.; Çınar, O.; Akgül, M.; Tuna, B.; Sancak, Eyüp Burak; Sıddıkoğlu, Duygu
[No abstract available]
Effect of preoperative urine culture timing on postoperative outcomes of retrograde intrarenal surgery: Preliminary results of the RIRSearch study
(Elsevier, 2025) Yazıcı, C. M.; Şahin, M. F.; Teke, K.; Şimşeko, M. F.; Tuna, M. B.; Basataç, C.; Çınar, O.; Sıddıkoğlu, Duygu; Sancak, Eyüp Burak
[No abstract available]
The Effect of Anti-HLA Antibodies on Graft Rejection after Renal Transplantation: A Retrospective Study
(Wiley, 2025) Özkanay, Hayat; Aksoy, Rasime Derya; Yılmaz, Banu; Uslu, Adam; Kurt, Hasan Anıl
[No abstract available]
Evaluation of triply periodic minimal surface geometries in 3D-printed PLA scaffolds for chondrogenic differentiation
(Wiley, 2025) Kılıç, Mahmut Alp; Akyürek, Mustafa; Abidnejad, Roozbeh; Karakoç, Alp
Triply periodic minimal surface (TPMS) scaffolds are gaining attention in tissue engineering due to their continuous and interconnected porous architecture. In this study, three TPMS geometries-Gyroid, Diamond, and I-WP-were fabricated from polylactic acid (PLA) using fused deposition modeling (FDM), with all scaffolds designed to maintain the same overall porosity. Scaffold characterization included scanning electron microscopy (SEM), microcomputed tomography (micro-CT), compressive mechanical testing, and surface wettability analysis. Although porosity was constant, differences in Equivalent Circular Diameter (ECD) values were observed among the geometries, reflecting variations in pore morphology. Adipose-derived stem cells (ADSCs) were seeded onto the scaffolds and cultured under chondrogenic differentiation conditions for 21 days. Cell viability, gene expression (Col2, Col10, Sox9), and protein levels were assessed using RT-PCR and Western blot. All scaffold geometries supported cell attachment and chondrogenic differentiation to varying degrees. The Diamond geometry showed the highest chondrogenic marker expression at the mRNA level, while the Gyroid geometry promoted more stable protein expression with reduced hypertrophic signaling. These findings demonstrate that scaffold geometry, even under identical material and porosity conditions, can influence stem cell behavior. The results offer valuable insights for optimizing TPMS-based scaffold designs in cartilage tissue engineering applications.
Pediatric earthquake-related amputations: associations with fasciotomy, crush syndrome, and entrapment duration
(Springer Heidelberg, 2025) Pazarcı, Özhan; Battal, Vahit Erdal; Gökmen, Mehmet Yiğit; Sönmez, Emre; Çiçek, Oğuzhan; Uslu, Hakan
Background Pediatric earthquake victims face unique challenges due to their distinct physiology, vulnerability to crush and compartment syndromes, and long-term functional and psychosocial needs. While adult earthquake-related amputations have been described, comprehensive pediatric-focused analyses remain scarce. Methods We conducted a retrospective study of 54 pediatric patients who underwent earthquake-related amputations following the February 6, 2023, Türkiye double earthquakes. Demographics, amputation characteristics, fasciotomy, crush syndrome, entrapment under debris, intensive care unit (ICU) admission, and early outcomes were systematically evaluated. Results Lower extremity amputations predominated (79.6%), with bilateral limb loss in 18.5% of patients. Fasciotomy was performed in 40.7% and was associated with shorter entrapment duration (p = 0.023), longer hospitalization (p = 0.027), and absence of debris entrapment (p = 0.019). Crush syndrome (25.9%) was linked to longer hospital stay (p = 0.017) and higher ICU admission (p = 0.043). Debris entrapment (13.0%) significantly increased the risk of thoracic trauma (p = 0.046) and ICU requirement (p = 0.033). Notably, no fasciotomy was performed in entrapped children. Older age, crush syndrome, and debris entrapment were significantly associated with ICU admission. Conclusions This study provides an early description of pediatric earthquake-related amputations. Fasciotomy appeared most beneficial when performed shortly after rescue, whereas prolonged entrapment was linked to systemic compromise and critical care needs. Crush syndrome was associated with greater resource utilization. These early descriptive findings underscore the importance of pediatric-specific considerations in disaster preparedness and highlight priorities for future multicenter and comparative research.
Avoiding radiation exposure during retrograde intrarenal surgery; a RIRSearch score for predicting longer fluoroscopy times
(Springer, 2025) Ozman, Oktay; Şimşekoğlu, Fatih; Şahin, Mehmet Fatih; Başataç, Cem; Akgül, Murat; Çakır, Hakan; Çınar, Önder; Sancak, Eyüp Burak
The aim of this study was to identify preoperative and perioperative predictors of radiation exposure during retrograde intrarenal surgery and to develop a scoring system to estimate intraoperative fluoroscopy time. Data from 753 patients who underwent retrograde intrarenal surgery for renal stones were obtained from a multicenter database. All procedures were performed under general anesthesia using fluoroscopy. Fluoroscopy time, recorded in seconds, was the primary outcome. Ordinal regression analysis was applied to evaluate the association between clinical variables and fluoroscopy duration. A predictive score was developed based on statistically significant factors. The performance of the score was tested using receiver operating characteristic curve analysis and a calibration plot.The mean fluoroscopy time was 58 seconds, while the median was 5 seconds. In 140 procedures, fluoroscopy time exceeded 120 seconds. Six parameters were independently associated with longer fluoroscopy use: absence of preoperative ureteral stenting, low stone density (<1000 Hounsfield units), small stone burden (<250 cubic millimeters), multiple stone localizations, failure of ureteral access sheath insertion, and use of large-caliber sheaths (>= 10-12 French). Each parameter was assigned a weighted value, generating a score ranging from 0 to 15. The scoring system demonstrated excellent discriminatory ability (area under the curve: 0.901). A score of 10 or more predicted fluoroscopy duration above 120 seconds with 87.5% sensitivity and 86.2% specificity.The RIRSearch Score is a practical tool for anticipating prolonged radiation exposure before retrograde intrarenal surgery. Surgeons may use this model to minimize unnecessary fluoroscopy and enhance occupational safety.
A note on the history of Hirschsprung's disease, and an over 120 years apology
(Springer, 2025) Celayir, Ayşenur; Çetiner, Handan; Aldırmaz Ağartan, Canan; Günaydın, Reyhan; Celayir, Arın
In 1886, Harald Hirschsprung presented what he believed to be a new and rare condition at the Berlin Congress for Children's Diseases. In 1888, still unaware of earlier reports, he published a paper titled Constipation in Newborns as a Consequence of Dilation and Hypertrophy of the Colon, suggesting that the enlargement of the colon was congenital. Although he noted a narrowing of the rectum in his initial case, Hirschsprung attributed this condition to a dilated intestine rather than a narrowed rectum. In fact, F. Ruysch had described a case of over-enlarged colon as early as 1691, and in 1800, D. Battini published another case of severe constipation posthumously. Between 1825 and 1888, around 20 similar cases had been documented in medical literature. K. Tittel was the first person to draw attention to the narrow rectum and the absence or scarcity of ganglion cells in this region in 1901. However, he did not identify this as the exact cause of the disease, This was evident not only in his own article but also in references to his work in other publications. Despite this fact in the literature, the disease is known as Hirschsprung Disease. Given the historical and scientific context, it may be time to reconsider the attribution of K. Tittel's discovery and to recognize the significant contributions of him in understanding of this disease.
Outcomes of retrograde intrarenal surgery in patients on anticoagulant or antiplatelet therapy: a multicenter matched case-control study by the RIRSearch Study Group
(Springer, 2025) Şimşekoğlu, Muhammed Fatih; Ozman, Oktay; Şahin, Mehmet Fatih; Çakır, Hakan; Teke, Kerem; Çınar, Önder; Akgül, Murat; Sancak, Eyüp Burak; Sıddıkoğlu, Duygu
Purpose This study aimed to assess the outcomes of various perioperative management strategies employed during retrograde intrarenal surgery (RIRS) in patients receiving anticoagulant (AC) or antiplatelet (AP) therapy. Methods In this multicenter retrospective matched case–control study, we included patients with nephrolithiasis who received AC or AP therapy and underwent RIRS. The control group consisted of patients not receiving AC/AP therapy. Group 1 included patients who discontinued AC/AP treatment prior to RIRS, whereas Group 2 comprised patients who also discontinued AC/AP therapy but received bridging anticoagulation. The primary endpoints were surgical success and RIRS-related complications. These outcomes were assessed using non-contrast abdominopelvic computed tomography (CT) scans obtained during the first postoperative month. Results In the final analysis, Group 1 and Group 2 each comprised 50 patients, while the control group consisted of 56 patients. The mean age was 59.36 ± 8.86 years in Group 1, 59.96 ± 9.70 years in Group 2, and 56.59 ± 11.56 years in the control group (p = 0.452). Surgical success was significantly lower in Group 2 (p = 0.026), and the need for auxiliary procedures was significantly higher in this group (p = 0.009). Although perioperative complications tended to be higher in Group 2 (p = 0.053), no statistically significant differences were observed in postoperative or overall complication rates. Conclusions Patients undergoing RIRS with bridging anticoagulation demonstrated lower surgical success rates and a higher need for auxiliary procedures. These findings underscore the importance of close monitoring and individualized perioperative management in this high-risk patient population.
Chronic low back pain and exercise: a molecular perspective on aerobic and anaerobic core training
(Springer, 2025) Aykora, Emrah; Akar, Ali; Eroğlu, Hüseyin Avni
Chronic low back pain (CLBP) remains a significant challenge for clinicians, and a substantial percentage of adults experience it at some point in their lives. Non-pharmacological treatments have gained attention for managing pain through aerobic and anaerobic core exercises. However, studies on humans and animals have yielded conflicting results regarding the type of exercise and its effect on pain sensation. The pain sensitivity of CLBP patients largely depends on their physiological and psychological conditions. The most studied and supported non-drug treatments for managing CLBP are aerobic core workouts. Recently, new research has also shown promising benefits of anaerobic core exercises, which can help reduce discomfort. Both aerobic and core anaerobic exercises have distinct yet complementary roles in managing CLBP. Aerobic training enhances overall health and endurance, while core anaerobic exercises focus on stabilization and muscular support. Understanding how they work individually and together can help create more effective, personalized exercise plans for long-term CLBP management. These exercises are especially effective in correcting postural issues and lowering mechanical stress on the lumbar spine. Although the exact mechanisms are still unknown, both types of exercises have the potential to lessen pain. This scoping review discusses the pathophysiological processes and exercise-induced hypoalgesia related to CLBP therapy. Additionally, it explores the pain-related molecular mechanisms associated with both aerobic and anaerobic core exercises.
Evaluating Large Language Model Adherence to AAOS Knee Osteoarthritis Guidelines: A Comparative Study of ChatGPT and NotebookLM
(Springer Heidelberg, 2025) Yıldız, Cemil; Gökmen, Mehmet Yiğit; Utlu, Çetin; Karabay, Elif Sude; Tanık, Uğur; Pazarcı, Özhan
Purpose This study evaluated how closely large language models (LLMs), specifically ChatGPT (OpenAI) and NotebookLM (Google), adhere to orthopedic guidelines. The objective was to determine whether AI-generated reasoning aligns with the 2021–2022 American Academy of Orthopaedic Surgeons (AAOS) clinical practice guidelines for knee osteoarthritis (OA). Methods A mixed-methods design combined quantitative concordance scoring with qualitative content analysis. Thirty-three decision points covering non-arthroplasty and surgical management were derived from AAOS guidelines. Structured Population–Intervention–Comparison–Outcome (PICO) prompts were presented to each model. Two orthopedic surgeons independently rated all outputs using a four-domain rubric assessing accuracy, evidence reasoning, additional information, and knowledge integration (0–4 scale). Concordance was classified as full (4), partial (3), or discordant (≤ 2), with disagreements resolved through consensus. Inter-rater reliability was almost perfect (weighted κ = 0.87). Results ChatGPT achieved a mean composite score of 3.67 ± 0.92, and NotebookLM 3.55 ± 0.87, with no significant difference between models (p = 0.18). Full concordance with AAOS recommendations occurred in 84.8% of ChatGPT responses and 75.8% of NotebookLM responses. Both models performed consistently in high-evidence domains such as NSAID therapy, tranexamic acid use, and weight-loss counseling. Variability increased in limited-evidence or technology-driven areas. Partial concordance reflected the omission of evidence qualifiers, while discordant responses involved overstated or speculative interpretations. Conclusion Both LLMs demonstrated strong alignment with evidence-based orthopedic reasoning. ChatGPT showed slightly higher fidelity to recommendation strength, whereas NotebookLM provided broader contextual interpretation. Structured, guideline-oriented prompting may enhance AI reasoning consistency and support the potential role of LLMs as complementary tools for evidence translation and orthopedic education.
The Effect of Oleuropein on the Treatment of Allergic Rhinitis
(Georg Thieme Verlag Kg, 2025) Çil, Özge Çağlar; Büyük, Başak; Eroğlu, Hüseyin Avni; Şehitoğlu, Hilal
Introduction Allergic rhinitis is a disease that negatively affects social and work life and sometimes does not respond to many treatments. Therefore, new treatments are needed. For the prevention and treatment of allergies, oleuropein has been emphasized, and positive results have been shown in the literature. Objective To investigate the effects of general and topical oleuropein during the allergic rhinitis period and the histopathological changes in the nasal mucosa compared with steroid nasal sprays and control group in rats. Methods We developed an experimental animal model with 44 rats divided into 6 groups. Except for the control group, the allergic rhinitis in the other five groups was created with ovalbumin. As treatment, saline was administered to group 3, steroids, to group 4, oleuropein, to group 5, and steroids and oleuropein were administered to group 6. The effects of the drugs were examined histopathologically and the levels of immunoglobulin E (IgE) in the blood were compared. Results Considering the symptomatic findings in rats, we could observe that allergic rhinitis occurred. Based on the IgE levels and histopathological findings, we have statistically shown that oleuropein may be effective in treatment of allergy rhinitis. Conclusion Oleuropein has been shown to be useful in the treatment of allergic rhinitis in an animal model, but further studies are needed before it is introduced into the medical practice.
Lactate-albumin ratio improves combined predictive value of qSOFA and MEWS for 30-day mortality in ICU patients with sepsis: A retrospective cohort study
(Lippincott Williams & Wilkins, 2025) Ünal Çetin, Ece; Kurtkulağı, Özge; Kamış, Fatih; Daş, Murat; Şimşek, Esen; Çetin, Adil Uğur; Demirer Aydemir, Ferhan; Beyazit, Yavuz
Evaluating disease severity and predicting adverse outcomes using various risk prediction tools in early disease stages is essential to reduce sepsis-related mortality. Unfortunately, there is still no clear consensus on the best score. The present study aimed to develop and validate a multivariable risk prediction model for 30-days mortality by combining the lactate-to-albumin (L/A) ratio, Modified Early Warning Score (MEWS), and quick Sequential Organ Failure Assessment (qSOFA) in sepsis patients admitted to the intensive care unit (ICU). This retrospective study included ICU patients with suspected sepsis. We computed L/A ratio, MEWS, and qSOFA within 24 hours of ICU admission. Patients were followed until either death/hospital discharge or 30 days, whichever came first. The predictive performance of each scoring system and their combinations was assessed using logistic regression and receiver operating characteristic curve analyses. A total of 130 patients with sepsis admitted to the ICU were included in the study. The mortality rate was 63.07% (82/130). A higher L/A ratio, MEWS, and qSOFA were found to be associated with mortality in ICU sepsis patients. A statistically significant difference in terms of predicting mortality was demonstrated in the pairwise comparison after combining the L/A ratio with both the qSOFA and MEWS (difference between areas: -0.098, P = .011 and difference between areas: -0.098, P = .013 respectively). Mortality models combining L/A ratio with selected clinical variables have improved mortality prediction performance compared with models that use MEWS and qSOFA alone. The L/A ratio at ICU admission provide valuable prognostic information for predicting 30-days mortality in sepsis patients. Combining these ratio with MEWS and qSOFA improves the accuracy of predicting mortality in patients with sepsis.
Knowledge and attitudes toward HIV/AIDS among Turkish clinical medical and dental students
(Wiley, 2025) Sezer, Berkant; Aydoğdu, Tuğba; Ata, Batuhan
Objectives Despite advances in HIV/AIDS treatment and prevention, persistent knowledge gaps and stigmatizing attitudes among healthcare trainees emphasize the need for early educational interventions to promote ethical and non-discriminatory care for people living with HIV/AIDS (PLWHA). This study aimed to assess and compare HIV-related knowledge and attitudes among clinical medical and dental students. Methods A cross-sectional, questionnaire-based survey was conducted among clinical-level students at a public university in Türkiye. Participants included fourth- to sixth-year medical students and fourth- to fifth-year dental students. The questionnaire assessed general HIV/AIDS knowledge, transmission routes, post-exposure prophylaxis and attitudes toward PLWHA. Data were analysed using descriptive statistics, independent samples t-test, Mann–Whitney U test and chi-square tests. Results Of 528 eligible students, 504 completed the survey (260 medical, 244 dental). Medical students scored significantly higher than dental students across all knowledge domains (p < 0.001) and demonstrated more positive attitudes (p < 0.001). However, both groups' overall knowledge levels were categorized as “weak,” and their attitudes remained “negative.” Common misconceptions included limited awareness of the “Undetectable = Untransmittable” principle, with only 11.5% of all students answering this item correctly, and false beliefs about transmission via casual contact, saliva, or shared utensils. Conclusions While medical students performed better, widespread deficiencies and stigmatizing beliefs across both groups indicate a need for curriculum reform. HIV-related education should integrate biomedical content with ethical reasoning, stigma reduction, and patient-centred approaches. Early, experiential learning may help foster more informed and inclusive attitudes among future healthcare professionals.
Effectiveness of Duct Excision Procedures in Detecting Preneoplastic and Malignant Lesions in Pathological Nipple Discharge: A Retrospective Cohort Study
(Wiley, 2025) Ata, Batuhan; Karadağ, Volkan; Çetin, Kenan
Background and Aims Nipple discharge ranges from benign to pathological, indicating inflammation or epithelial proliferation. In 5%–28% of cases, pathological nipple discharge (PND) may indicate breast carcinoma. Our objective was to evaluate the detection rates of malignant and high-risk lesions (HRL) in patients undergoing major duct excision (MDE) and microductectomy for diagnostic purposes due to PND and to assess the need for re-excision in malignancies. Method Patients diagnosed with PND between October 2015 and December 2023 underwent duct excision procedures after physical, imaging, and histopathological examinations, if necessary. Patients with malignancies detected by histopathological evaluation underwent oncological procedures and were excluded from the study. Results Among 118 patients, 80 underwent microductectomy and 38 underwent MDE. Intraductal lesions (ILs) were detected in 62% of cases, with higher detection rates in the microductectomy group (69% vs. 47%, p < 0.03). Of these lesions, 23 were classified as HRL (24% in the microductectomy group vs. 11% in the MDE group, p = 0.09). Malignancy was detected in 16 patients (13.6%), with a higher rate in the MDE group (18% vs. 11%, p = 0.3). Five patients required re-excision for clear surgical margins, with no significant difference between the groups (microductectomy: n = 2; MDE: n = 3, p = 0.3). Conclusion The malignancy detection rate was slightly higher in the MDE group; however, this difference was not statistically significant. Similarly, there was no significant difference in the need for re-excision. Microductectomy, which preserves lactation function, may be preferred for premenopausal individuals or those considering future pregnancies when clinical presentation supports single-duct involvement. The differing distribution of IL and HRL between procedures reflects the pathology associated with their respective clinical indications rather than a difference in diagnostic performance.
Feeling Underqualified and out of My League: Motivational and Affective Paths to Adaptive and Maladaptive Behaviors
(Sage Publications Inc, 2025) Köseoğlu, Gamze; Keem, Sejin; Karaeminoğulları, Ayşegül; Erdoğan, Berrin; Bauer, Talya N.; Sancak, Eyüp Burak
This study explored the motivational and affective implications of perceived underqualification, specifically examining how it leads to increased levels of envy and help-seeking behaviors. We predicted that envy and help seeking behaviors would in turn indirectly relate to interpersonal deviance and task performance. We further hypothesized that two psychological resources, hope and self-efficacy, would moderate the relationships between perceived underqualification, envy, and help seeking. We tested our model with a sample of 149 medical school students who were undergoing a clinical rotation as well as their rotation coordinators at a university hospital located in northwestern Turkey. Data collection spanned four waves, from the first day of their rotation to the end of that one-month rotation. Results supported positive indirect effects between perceived underqualification and task performance via help seeking, and between perceived underqualification and interpersonal deviance via envy. Further, hope moderated the relationship between perceived underqualification and task performance via help seeking, and self-efficacy moderated the relationship between perceived underqualification and envy.
Endoloop Versus LigaSure for Appendiceal Stump Closure in Pediatric Laparoscopic Appendectomy: A Multicenter Prospective Trial
(Mary Ann Liebert, Inc, 2025) Kurtuluş, Şenay; Suzen, Alev; Kaya Terzi, Neslihan; Çelik, Serkan Yaşar
Background: Appendiceal stump closure is critical in laparoscopic appendectomy (LA) to prevent complications such as stump leakage and intra-abdominal abscess formation. This study aims to evaluate the safety and effectiveness of LigaSure™ versus Endoloop for appendiceal stump closure in pediatric LA. Methods: This prospective multicenter comparative study included 199 pediatric patients who underwent LA between May 2021 and October 2023 at two pediatric surgery clinics. Patients were allocated to the LigaSure group (n = 74) or Endoloop group (n = 125) based on the surgeon’s intraoperative preference. Data collected included demographic characteristics, laboratory and radiological findings, intraoperative details, postoperative complications, and histopathological measurements of appendiceal and lumen diameters. Statistical analyses were performed using the independent samples t-test and chi-square test, with significance at P < .05. Results: No significant differences were observed between groups regarding age (P = .670), gender (P = .439), leukocyte count (P = .072), or C-reactive protein levels (P = .368). Complicated appendicitis was more prevalent in the LigaSure group (12.2%) compared to the Endoloop group (5.6%). No intra-abdominal abscesses or stump leakage were reported in either group. Histopathological analysis revealed no significant difference in mean appendiceal diameter (LigaSure: 8.9 ± 0.2 mm; Endoloop: 8.9 ± 0.1 mm; P = .743) or lumen diameter (P = .096). The largest lumen diameter measured in appendix specimens was 5113 μm, while the smallest was 255.6 μm (P = .096). No cases of intra-abdominal abscess or stump leakage were reported. The mean hospital stay was comparable (LigaSure: 2 ± 0.2 days; Endoloop: 2 ± 0.1 days; P = .068). Conclusion: LigaSure™ is a safe and effective alternative to Endoloop for appendiceal stump closure in pediatric LA. The device’s ability to provide a secure seal makes it a reliable option, even in cases of complicated appendicitis.
The Impact of Preoperative JJ Stent Diameter on Retrograde Intrarenal Surgery: A RIRSearch Group Study
(Mary Ann Liebert, Inc, 2025) Şahin, Mehmet Fatih; Ozman, Oktay; Teke, Kerem; Şimşekoğlu, Muhammet Fatih; Akgül, Murat; Başatac, Cem; Çınar, Önder; Sıddıkoğlu, Duygu; Sancak, Eyüp Burak
Introduction: A JJ stent placed before retrograde intrarenal surgery (RIRS) may passively dilate the ureter and facilitate ureteral access sheath (UAS) implantation. No studies have examined the significance of preoperative JJ stent diameter, even though numerous studies have shown that UAS insertion is simpler in patients with them. Our study examines the relationship between preoperative ureteral stent caliber and UAS placement and RIRS results. Materials and Methods: A total of 655 patients with known preoperative double-J stent size before RIRS were analyzed. The patients were categorized into two groups based on their preoperative stent diameter (Group 1: 4.8 Fr and Group 2: 6 Fr). Demographic and clinical data of the patients, stone characteristics, surgical data, perioperative and postoperative complications, duration of hospitalization, and stone-free rates (SFRs) were analyzed for comparison. Results: The groups contained 323 and 332 patients. The demographic data of the two groups were similar. There was no statistically significant difference between SFR, UAS insertion rate, hospitalization time, and complications. The success rate of placing a UAS with a higher caliber was statistically significantly higher in those with a 6 Fr JJ stent than in those with a 4.8 Fr stent (P = .001). The operation time was also shorter in the group with a thicker stent (P = .003). Conclusions: Our data suggest that while the preoperative JJ stent diameter does not significantly affect overall UAS insertion success, complication rates, or postoperative stone-free status, using a 6 Fr stent facilitates the placement of larger UAS calibers and may decrease operation time. Consequently, although both stent diameters are efficacious, selecting a 6 Fr stent may provide procedural benefits without jeopardizing safety or results.
Do fistula flow rate and fistula location have any effects on heart failure developing in patients with arteriovenous fistula?
(Bmc, 2025) Yümün, Gündüz; Donbaloğlu, Mehmet Okan; Gürkan, Selami; Gür, Özcan; Demirkıran, Aykut
Background This study aims to explore the effects of arteriovenous fistula locations in the arm and fistula flow rates on the potential development of heart failure in patients with arteriovenous fistula (AVF). Material and methods A total of 116 patients with AVF due to chronic kidney disease were retrospectively reviewed between January 2022 and August 2022. Fifty-six patients with distal AVFs and 60 with proximal AVFs were compared in terms of demographic, clinical, and echocardiographic characteristics. Fistula flow rates were assessed using Doppler ultrasonography, while cardiac parameters were evaluated with echocardiography. The correlation between fistula location and cardiac parameters was analyzed using ROC analysis. Results The mean AVF blood flow rate was 1.47 (0.57–2.9) L/min for proximal fistulas and 0.85 (0.52–2.3) L/min for distal fistulas. There were statistically significant differences between the proximal and distal AVF groups regarding cardiac index, cardiac output, and cardiopulmonary recirculation values (p< 0.001). According to the New York Heart Association classification, Class III can be categorized as high cardiac output failure (HCOF), as cardiac index was calculated at 6.87 ± 1.65 L/min/m² (4.7–9.4), fistula flow rate at 2.60 L/min (2.1–2.9), and cardiac output at 8.08 ± 0.69 L/min. Conclusions When heart failure develops in patients with AVF, underlying heart disease should not be the sole factor considered. Proximal high-flow AVFs, in particular, may contribute to heart failure development and warrant careful monitoring.
Comparative efficacy of erector spinae plane block versus surgeon-performed intraoperative intercostal nerve block in video-assisted thoracoscopic surgery: a retrospective analysis
(Bmc, 2025) Kına, Soner; Batıhan, Güntuğ; Türkan, Hüseyin; Bektaş, Yekta
Background Video-assisted thoracoscopic surgery (VATS) offers reduced postoperative pain and faster recovery, yet optimal analgesia remains essential. Regional anesthesia techniques, such as the erector spinae plane (ESP) block and intercostal nerve block (ICNB), are commonly employed. This study compares preoperative ESP block with surgeon-performed intraoperative ICNB in VATS patients. Methods In this retrospective study, 82 patients (≥ 18 years; ASA I–III) underwent elective VATS between January 2020 and December 2022 were analyzed. Forty patients received a postoperative ESP block and 42 an intraoperative ICNB. Primary outcomes included postoperative pain scores using the Visual Analog Scale, postoperative peak expiratory flow (PEF), postoperative IV opioid analgesic use, drainage time, and hospital length of stay. Results Baseline demographics were similar. VAS scores were comparable at postoperative 1, 3, 6, 12 and 24 h. At postoperative 48 h, the ICNB group had significantly lower VAS scores (4.17 ± 1.03 vs. 4.78 ± 1.03; p = 0.00987). No significant differences were observed in postoperative iv opioid analgesic use, drainage time or hospital stay. Conclusions Both techniques provide effective early analgesia in VATS, with ICNB showing prolonged pain relief. Further prospective studies are warranted.

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